JMIR Publications

ABSTRACT

Background:

Nonadherence to immunosuppressants after kidney transplantation increases sharply from 11% in the early post-transplant period to 31% at 3 months, and the associated economic burden amounts to approximately $100,000–300,000 per year. Mobile apps have emerged as a potential means to address declining medication adherence.

Objective:

This study aimed to identify the current landscape of commercially available mobile apps designed to support self-management in kidney transplant recipients, to evaluate their quality and functionality using the Mobile Application Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality score (IMS functionality score), and to propose guidelines for developing domestic (Korean) apps.

Methods:

From January 13 to 21, 2026, we searched the iOS Apple App Store and the Android Google Play Store using six keywords, including “kidney transplant” and “kidney graft,” and selected apps that met the inclusion criteria (n=6). Two raters (H and CM) independently evaluated each app using the MARS (29 items, 5-point scale) and the IMS functionality score (11 functions). Interrater reliability was ICC=.83 and Cohen’s kappa=.88.

Results:

The mean MARS score across the six apps was 4.06±0.96. Subscale scores were highest for Aesthetics (4.22±0.81), followed by Functionality (4.13±0.80), Information (4.11±0.75), and Engagement (3.80±1.32). The mean IMS functionality score was 5.67 out of 11 functions, and the “Evaluate data” function was included in only one app (16.7%). Analysis of the three highest-scoring apps (Mizu-Your CKD Companion, Transplant Center Medication Reminder, and AlloCare Transplant Health) indicated that structured interventions, personalized feedback, and features linking patients with healthcare professionals were key elements.

Conclusions:

Commercial apps performed well in providing information and enabling data logging, but were weak in clinically interpreting collected data and delivering tailored interventions. Future app development should prioritize stage-specific designs across the transplant trajectory, risk-based alerts, and bidirectional communication features between clinicians and patients.